Permit (6) t CITY OF TIGARD MASTER PERMIT
` 1 COMMUNITY DEVELOPMENT Permit#: MST2023-00474
Date Issued: 01/22/2024
T t G AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DC20300
Jurisdiction: Tigard
Site address: 13867 SW 172ND AVE
Subdivision: RIVERSIDE AT SCHOLLS MEADOW Lot: 40
Project: Riverside at Scholls Meadow, Lot 40
Project Description: New detached dwelling.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1016 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1450 sf Garage: 390 sf Front: 12 Smoke
Yes
Dwelling Units: 1 Third: 0 sf Right: 3 Detectors:
Total: 2466 sf Value: $438,661.62 Rear: 10
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 1 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Drains: 0 Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Bckflw Prevntr: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 4 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Y
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2466
Owner: Contractor:
RIVERSIDE HOMES LLC RIVERSIDE HOMES LLC Required Items and Reports(Conditions)
15350 SW SEQUOIA PKWY STE 320 17933 NW EVERGREEN PKWY 370 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97224 BEAVERTON,OR 97006
PHONE: PHONE: 503-645-0986
FAX: 503-690-2942
Total Fees: $50,683.14
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTE ION: Oregon law requir to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
oc9-nn1-M1n thrni, rl R 0c9-M1-Mall Vni, i fhfain n nnnv of tha rnloc nr rlirart nuactinnc to(11 imr.hu Tallinn Fn3 919 1 QR7 nr 1 RCM 119 93dd
Issued By: ��?`� Permittee Signature: 5 eT �}�� ( t ``D
Call 503.639. 5 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application
Residential RECEIVEID Folz OFFIC>•, l SE O\L\
NI Received
City of Tigard Date/B : G Permit No.: �` r � �
III SEP 14 2023 � 1
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : � �� Other Permit:S.1j/ _ 0"
I WARD Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: I I 7 2.3 p F IMI Supplemental Information
BUILDING DIVISION �: , fi_,,,._,,
{ ,.:- i i,ii:,•S ?r ; %i : . '1`Eii`2' P ' • >ixts &',, iQ', _ 14
#y���ys� ,�'
'� �'�-: ..�.. +'d i:`'rS�; � t> : .v.
Permit fees*are based on the value of the work performed.
❑� New construction El Demolition
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit forf the
+ a r '' ,.;.- lI
�;, . r {� „, .:. � : , work indicated on this applicarion. f
° ^'•ri ' �, £ :a a 8 y<t ES `.�}�, +�d.b `;",'% �a �._:",.•.:-' ,.,,. ��/n J 4
Valuation: $ ISLV.
❑✓ 1-and 2-family dwelling ❑Commercial/industrial •
❑Accessory building El Multi-family Number of bedrooms: 5
0 Master builder El Other:
Number of bathrooms: 3
y x� ;'''I'';;14fit ' ., . Total number of floors: 2 C351J1
Job site address: 13867 SW 172ND Ave New dwelling area: 2466 square feet 11.1541
City/State/ZIP: Tigard/OR/97140 Garage/carport area: 390 square feet t 0
Suite/bldg./apt.no.: Project name: Riverside at Scholls Meadow Covered porch area: square feet
Cross street/directions to job site: Roy Rogers & Jean Louise Rd Deck area: square feet
Other structure area: square feet
`; t 4 a 4,r ii'Q " dins t:0'lL' EpLii! it.
Subdivision: Riverside at Scholls Meadow Lot no.: 40 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: WCTM 2S 106DC20300 Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
z`<• � a?` n�i ram. t ; -. .
e k work indicated on this a lication.
Construction of single family detached residence ' Valuation: $
Existing building area: square feet
New building area: square feet
;: '�.y• ': I E ', ,,;A* -•17, Number of stories:
,; ri gig: •.
Name: Riverside Homes Type of construction:
Address: 15350 SW Sequoia Pkwy, Suite 320 Occupancy groups:
City/State/ZIP: Portland, OR 97224 Existing:
Phone:( 971) 371-1310 Fax:( ) New:
r--" ;,,. 0 y �° 44', a r S �.e'�..%.': yk a «....> ,' ".rY' _fi ER��t f' F9' f �µ °#.k.
Business name: Riverside Homes
Structural plan review fee(or deposit):
Contact name: Jennifer Doty
FLS plan review fee(if applicable):
Address: 15350 SW Sequoia Pkwy, Suite 320
Total fees due upon application:
City/State/ZIP: Portland, OR 97224
Amount received:
Phone:(971 ) 371-1310 I Fax: :( )
k D
E-mail: jdoty@riversidehome.com � ` y�! h -' ._
tw;: Commercial and residential prescriptive installation of w y k, p
�: s yc' c
� �� '� `; � roof-top mounted Photovoltaic Solar Panel System.
Business name: Riverside Homes Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address: 15350 SW Sequoia Pkwy, Suite 320 Solar Installation Specialty Code checklist.
City/State/ZIP: Portland, OR 97224 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:( 971) 371-1310 Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lic.: 189148 Total fee due upon application: $201.60
Authorized signature: ' �a—r� This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry
Print name: Jennifer Doty Date: $/28/23
Service Board.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OFFICE USE ONLY
City g of Tigard Received
Date/By:
Permit No.:
• 13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
I Phone: 503.718.2439 Fax: 503.598.1960
I t r I`I 24-Hour Inspection Line: 503.639.4175 ❑ Electrical El Plumbing ❑ Mechanical
Internet: www.tigard-or.gov ❑ Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW l'cs No NiA
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ® 0 0
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ® 0 0
3 Verification of approved plat/lot. N 0 0
4 Fire district approval required. Name of district: Tualtin Valley Fire&Rescue ® 0 0
5 Septic system permit or authorization for remodel. Existing system capacity_ 0 0 10
6 Sewer permit. N 0 0
7 Water district approval. ® 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. ® 0 ❑
9 Erosion control EJ plan ❑permit required. Include drainage-way protection,silt fence design and location of catch- ® 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state ® 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ® 0 0
there is more than a 4-fl.elevation differential,plan must show contour lines at 2-fl.intervals);location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ® 0 ❑
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, ® 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ® 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ® 0 0
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- ® ❑ 0
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ® 0 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 0
systems,see item 22,"Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ® 0 0
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. ® 0 0
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required ® ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or 54 0 0
architect licensed in Ore.on and shall be shown to be a I.licable to the •ro'ect under review.
JURISDICTIONAL SPECIFICS
23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ® 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ® ❑ 0
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ® ❑ ❑
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ 0
27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 0
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ® 0 0
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, 0 0 El
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, 0 0
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB)
Mechanical Permit Application FOR OFFICE I SE ON►.\,
RECEIVE h eceived permit No.: 7
-IN City of Tigard �ateBy: '
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
SEP 14 2023 Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960Date/By:
Inspection Line: 503.639.4175 Date Ready/By: Jurist 0 See Page 2 for
TIGARD Supplemental Information
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: PP
,,;i ` ', . -` "` " -`""' Mechanical permit fees*are based on the value of the work
✓Q New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition D Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
❑✓ 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder ❑Other
Description Qty. Ea. Total
:s? , ';� Heating/cooling:
xargia fi t t ° t;r" r e , n .e ++a . 46.75
c t } Air conditioning 1 46.75
Job site address: 13867 SW 172ND Ave Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP: Tigard/OR/97140 Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Duct work 23.32
Cross street/directions to job site: Roy Rogers & Jean Louise Rd
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Riverside at Scholls Meadow I Lot no.: 40
Other fuel appliances:
Tax map/parcel no.: WCTM 2S106DC20300 Water heater 1 23.32 23.32
4:� Gas fireplace/insert 1 33.39
33.39
,,'' p� ?ti,, :g< -.,ate-.�.� , ��� r .__ ''' ''"' Flue vent for water heater or gas
Construction of single family detached residence fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
a 5 sit , Other: 23.32
:4:,,„„vi . ,,v „ -'4;i",it,L Environmental exhaust and ventilation:
Name: Riverside Homes Range hood/other kitchen
equipment 1 33.39 33.39
Address: 15350 SW Sequoia Pkwy, Suite 320 Clothes dryer exhaust 1 33.39 33.39
Single-duct exhaust(bathrooms,
OR 97224
City/State/ZIP: Portland, toilet compartments,utility rooms) 5 23.32 116.6
Phone:(971 ) 371-1310 Fax ( ) Attic/crawlspace fans 23.32
,, ir'x .: 7 .""% �; * :T s Other: 23.32
. ,,,,
t., ,r � ,. =' Fuel piping:
Business name: Riverside Homes $14.15 for first four;$4.03 for each additional
Contact name: Jennifer Doty Furnace,etc. 1
Gas heat pump
Address: 15350 SW Sequoia Pkwy, Suite 320 Wall/suspended/unitheater
City/State/ZIP: Portland, OR 97224 Water heater 1
Fireplace 1
Phone:(971 )371-1310 Fax: :( ) 1
Range
E-mail: jdoty@riversidehome coin Barbecue
a• s. «' r es dryer(gas) ,
W ur W sa �t " � Cloth
y
�.r ._.. , Other:
Business name: Proheating &Cooling " * .,:..
Address: 2123 NE Aloclek Dr, Suite 1209 Subtotal
Minimum permit fee($90.00)
City/State/ZIP: Hillsboro/OR//97124 Plan review(25%of permit fee)
Phone:( 971) 205-4989 Fax:( ) State surcharge(12%of permit fee)
TOTAL PERMIT FEE
CCB lic.: 209001
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ,, * Fee methodology set by Tri-County Building Industry Service Board
Print name: Jennifer Doty Date: 8/28/23
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi Famil Fee Schedule:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PernutApp_040113.doc 2
Electrical Permit Application FOR OFFICE GSE oNl.v
Cl ofTigard JEC
E�v� Received
ty g DateivII 13125 SW Hall Blvd.,Tigard,OR 92 Plan Review
Phone: 503.718.2439 Fax: 503.598.196a[p 1 Date/B : Related Permit#:
Inspection Line: 503.639.4175 J C I" 2023 Ready Date/By: Suns: ® See Page 2 for
T I G A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
'::Y" ,by •'�`i; x? ; '` s.4 a4u1, r *, _ ..2 i., t` , a h..,_- ,. , ..,,
El New construction 0 Addition alter.
n:I'A� i"I!1 `" ' w ' Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: ❑where the available faultcurrentore O Marinas and boatyards.
ries.
s, " ' ;e of ' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
gym.: ,x ,' F, :. , 1 ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 13867 SW 172ND Ave 100HP or more. ❑"A","E","1-2","1-3",
0 Six or more residential units. occupancy.
City/State/ZIP: Tigard/OR/97140 ❑Health-care facilities. ❑Recreational vehicle parks.
Riverside at Scholls Meadow ❑Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: I Project name: 600 volts nominal.
❑Service or feeder 600 amps or more.
Cross street/directions to job site: Roy Rogers & Jean Louise Rd
Description Qty. Each 1 Total ( *
New residential single-or multi-family dwelling unit.
Subdivision: Riverside at Scholls Meadow 1 Lot#: 40 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: WCTM 2S106DC20300 Ea.add'1500 sq.ft.or portion 33.92 1
t o iAt2fftl' IL, Limited energy,residential 75.00 2
Construction of single familydetached residence (with above sq.ft.)
g Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
',; ✓ ,, `,A , . ' Y. ..sue." __° Services or feeders installation,alteration,and/or relocation
Name: Riverside Homes 200 amps or less 100.70 2
Address: 15350 SW Sequoia Pkwy, Suite 320 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland, OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(971 ) 371-1310 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 1 2
Branch circuits—new,alteration,or extension,per pane
' t#'2 �"r ' -� A.Fee for branch circuits with
Y,$1... �.` .mn P'...a .w�F_.4 .. ..,. '4siA; s{ „,xka:b"
Business name: Riverside Homes above service or feeder fee, 7.42 2
each branch circuit
Contact name: Jennifer Doty B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 15350 SW Sequoia Pkwy, Suite 320 branch circuit
City/State/ZIP: Portland, OR 97224 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971 ) 371-1310 I Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: jdoty@riversidehome.com Reconnect only 67.84 2
1 's `� ran ,* s Pump or irrigation circle 67.84 2
Business name: Sunlight Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 2804 NE 65th Ave, Ste. D panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: Vancouver/WA/98661 Additional inspection(1 hr min) 66.25/hr
Phone:(360) 518-7589 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: yegor@sunlightelectricinc.com Inspections for which no fee is
)
CCB Lie.: 172549 Electrical Lic.: C 30 Suprv.Lic.: 6652S s ecificall listed('/2hr min 90 00/hr
Exp 10/01/25 -r Q ?x '_� �w ',
Suprv.Electrician signature,required: Subtotal:
Print name: Sunlight Electric I Date: 8/28/23 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
I TOTAL PERMIT FEE:
Authorized signature: - �-
This permit application expires if a permit is not obtained within 180
Print name: Jennifer DotyDate: 8/28/23 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Pemuts\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
Fee for all residential s max, Description s Qty x Each Total
ystems combined: $75.00
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
s.-cificall listed(%z hr min)
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PemutApp_ELR_ERE.doc Rev 06/17/2015
Plumbing Permit Application
- Building Fixtures RECEIVE'..
City of Tigard Received
�+ p 2023 Date/By: Permit No.: l/
13125 SW Hall Blvd.,Tigard,OR 97223 J�r Plan Review T �
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit No.:
P CITY OF TIGARD Date By:
T 1 G A R n Inspection Line: 503.639.4175 ^ Date Ready/By: 7uris: 0 See Page 2 for
Internet: www.tigard-or.gov : I 1 . I VISION Notified/Method: Supplemental Information
-te . z..xr "xw.. jas -gr .r' .- ,
..,,� ^-.� :em S i.;,....; �. Y ••L .;Md. >�.5.:. „!pry.>$ t � ,:t.;y
y
.;;c _� �'� ;, ; .. i?. rr:,xRw yt� k ,, >:s r :!$� �' .,. . " ,ni%�cia.?e,�'s'. n"z . .k.: , " `' � .. Wr.,_w. .-pI
El New construction IfDemolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
`z sage max'.:-,tea " ` ""' r`` ' SFR(1)bath 312.70
✓ 1-and 2-familydwellingSFR(2)bath 437.78
❑ ❑Commercial/industrial
AccessorybuildingSFR(3)bath 1 500.32 500.32
El ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire
3 � t11 Site tilrtiesr( sq.ft.) Page2
, -„- .:i ,.,. , ,�.. ._ vas>,... ° .,_.. .., ,>� , w:
Job site address: 13867 SW 172ND Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140
Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: ( Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers & Jean Louise Rd Manholes 18.76
Rain drain connector 1 18.76 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Riverside at Scholls Meadow 1 Lot no.: 40 Fixture or item:
Tax map/parcel no.: WCTM 2S 106DC20300 Backflow preventer 31.27
, k ',$..'' ..'.T. -.:, -f; . r . :. Backwater valve 12.51
y ,m1.,. , 71'4; b iP:Ai'it t: $i' .'• • . 1 y r�'"
_.,` * °; z ,.. • *`;"i. :•t ti:-. Clothes washer 1 25.02 25.02
Construction of single family detached residence
Dishwasher 1 25.02 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
f, ' v4 ''', .` ,l R > t)):•'---- C . " Expansion tank 12.51
Fixture/sewer cap 25.02
Name: Riverside Homes
Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320
Garbage disposal 1 25.02 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 2 25.02 50.04
Phone:(971 ) 371-1310 Fax:( ) Ice maker 1 12.51 12.51
d ,
;: ; 1"f ax 2. e .;a Interceptor/grease trap 25.02
��, a �:: ZKw, s.�. . �. .:�� :- _�4_...=�i-4a`d� �. �;' ��� ,�•;< ;.
Business name: Riverside Homes Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Jennifer Doty
Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 6 25.02 150.12
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax: :( ) Tub/shower/shower pan 4 12.51 50.04
Urinal 25.02
E-mail: jdoty@riversidehome.com
Water closet 3 25.02 75.06
Water heater 1 37.52 37.52
Business name: H & H Mechanical Water piping/DWV 56.29
Address: 5757 SE Willow Ln Other: 25.02
City/State/ZIP: Milwaukie/OR/97267 Subtotal
Phone:(503) 975-9787 Fax:( ) Minimum permit fee: $72.50
CCB Lie.: 178122 Plumbing Lic.no.: PB414 Plan review (25%of permit fee)
State surcharge(12%of permit fee)
Authorized signature: / ;�'_ �_.._ TOTAL PERMIT FEE
Print name: Jennifer Doty Date: 8/28/23 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
C\Building\Petmits\PLMU-PetmitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Su I s ression S stems:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas Systems.
Water Service-each additional 100' 37.52 " .; ;.
Storm&Rain Drain-1st 100' 62.54 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
4r each additional$100.00 or fraction thereof,to
4:, . 15a and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge 1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
F`* a for "� . .M•7177. ' 4 ��.R . P �°. :4 Q # ° 4 IE ! ,
W4 ruled:. ,Pe 4# Rite Plan review is required for any of the following.
Please check all that apply.
Baptistry/Font Pp y'
ElBath Tub/Shower Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain ,, .. m. .., ..�� s't ,. . ' t,
❑
Garbage Domestic-non-food Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-'toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
• Plumbing Permit Application
• Building Fixtures RECEIVE FOR OFFICE l'SE ONI.\
Cityof Tigard Received
g Date/By: Permit No. p 0 q�q
in 13125 SW Hall Blvd.,Tigard,OR 97223 S E P i i, Plan Review �5� ��
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit No.:
Inspection Line: 503.639.4175 I I L A R l7 CITY OF TIGARD Date Ready/By: Iuris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
a r
p✓ New construction Id Demolition For special information use checklist
Description I Qty. I Ea. I Total
❑Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
. t r•t ,t >t txr , ;...;i. r. SFR(1)bath 312.70
❑r 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2
,w1, , ' ... i-J.:: d,t.a I s o .z .•. _x:; Site utilities:
Job sitenaddress: 13867 SW 172ND Ave Catch basin or area drain 18.76
Drywell,leach line,or trench drain 18.76
City/State/ZIP: Tigard/OR/97140 Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: Riverside at Scholls Meadow Manufactured home utilities 50.03
Cross street/directions to job site: Roy Rogers & Jean Louise Rd Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no.linear ft.: ) Page 2
Subdivision: Riverside at Scholls Meadow I Lot no.: 40 Fixture or item:
Tax map/parcel no.: WCTM 2S106DC20300 Backflow preventer 1 31.27 31.27
7 ..,. '. 11 ' r k ,ti w Backwater valve 12.51
y atG .`T`k.., .�,.. „ ,,1 ,,.
Clothes washer 25.02
Construction of single family detached residence
Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
„.
t - Expansion nk
1251
) � � � 1- Fixture/sewer cap 25.02
Name: Riverside Homes Floor drain/floor sink/hub 25.02
Address: 15350 SW Sequoia Pkwy, Suite 320 Garbage disposal 25.02
City/State/ZIP: Portland, OR 97224 Hose bib 25.02
Phone:(971 ) 371-1310 Fax:( ) Ice maker 12.51
� . Say `" Interceptor/grease trap 25.02
Business name: Riverside Homes Medical gas(value:$ ) Page 2
Primer 12.51
Contact name: Jennifer Doty Roof drain(commercial) 12.51
Address: 15350 SW Sequoia Pkwy, Suite 320 Sink/basin/lavatory 25.02
City/State/ZIP: Portland, OR 97224 Solar units(potable water) 62.54
Phone:(971 ) 371-1310 Fax: :( ) Tub/shower/shower pan 12.51
E-mail: jdoty@riversidehome.com Urinal 25.02
r 7 7, . .. Water closet 25.02
. ..'1. �.ti. ' '.. „ ''- . 44:-.., �,. , Water heater 37.52
Business name: Truscapes Water piping/DWV 56.29
Address: 7800 NE Walker Road Other: 25.02
City/State/ZIP: Hillsboro/OR/97124 Subtotal
Phone:(503)531-9216 Fax:( ) Minimum permit fee: $72.50
LCB#7962 Plan review (25%of permit fee)
CCB Lie.: PlumbingLic.no.:
State surcharge(12%of permit fee)
Authorized signature: „.. .._. ' TOTAL PERMIT FEE
Print name: Jennifer DotyDate: 8/28/23 This permit application expires if a permit is not obtained within 180 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
1.\Building\Permits'PLMU-PermitApp.doc 10/01/09 440-4616T(10/02/COM/WEB)
Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information •
Fee Schedule: Residential Fire Su' s ression S stems:
Footing drain-1"100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
Sewer-1st 100' 62.54 3,601 to 7,200 $233.20
7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 Medical Gas S stems:
Water Service-each additional 100' 37.52
Storm&Rain Drain-1st 100' 62.54
$1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' 37.52 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
,, each additional$100.00 or fraction thereof,to
i ° - HI� ., and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge 2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
uanri bt3 yl'e T w
.plane rf'Or : 7 t -! !� a t E t 9 's
Wat'3'erfo A "Ate Plan review is required for any of the following.
Please check all that apply.
Baptistry/Font PP Y
Bath Tub/Shower El Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinlder system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
-3"
-4"
Car Wash Drain ,,;144111 t° t'• rk i lW ( �sU4
Garbage -Domestic-non-food ❑ Isometric or riser diagram is required for new buildings
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal plumbing permit can be issued.
Other Fixtures:
C:\Users\npruett\Downloads\PLMF_PermitApp.doc 2
4e--- ---)a—'Etetr- Pczir (54"‘"--") /1•-- 0-\-- * tk -0 r--w--f-et
a Building Division
One & Two-Family Dwelling
TIGARD Fees Checklist
PERMIT INFORMATION: Application Date - FEE VERSION )C �
G
Permit#: ! ' `c c,�,�2s_004-7(y Plan #: �/ Floors: o
Valuation: Covered Porch: _l l�_—P Basement
0'438 GG1. 62
Bedrooms: S Deck: 1st Floor l 1 l
O r Le
WC (toilets) Deck Cover: �---- 2nd Floor t Ll Sb
Lavatories Patio Cover 31d Floor
Tub/shower Accessory Struct. R-3 Total .Li/ _(
40
Laundry Tray v Water Heater 1 /4110 Elec Garage 3, 0
Exhaust Vents Gas Flue Vents Total for Elec. 2 8G(
Backflow Prev. urnace / Heat Pump /� # for Electrical J`�'
'
BB ___--_—.. Gas Fireplace \i #Fuel LinesLi
FEES: Description: Fee App ' s: Fee Entered:
DC Prov Revw: Planning
Info Proc/Arch: Lg$2.00 (over 11x17) t
Info Proc/Arch: Sm$.50 (up to 11x17) 41
Metro CET: Residential Use
School CET: District: k f
Tigard CET: Admin L -
Tigard CET: ODHCS f
Tigard CET: AH
Electrical Permit: Permit Fee: t/----
Limited Energy: (....."*"-
12% State Surcharge
Mech. Permit: Permit Fee:
12% State Surcharge
Plumbing Permit: Permit Fee:
12% State Surcharge
Erosion Control: w/Permit-Ping
I:\Building\Forms\ResPlanCheckFees_Dec2022_AA.doc 12/21/22
Page 1
FOR OFFICE USE ONLY—SITE ADDRESS: It61 SW 11111 d Av&
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
! _ r Transmittal Letter
r i G n ii n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Hope Pollard DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
FROM: Jennifer Doty OCT 0 9 2023
COMPANY: Riverside Homes CITY OF TIGARD
PHONE: 971-371-1310 BUILDING DIVISION ,:
1,OU ed . 1209
EMAIL: jdoty@riversidehome.com
RE: 13867 SW 172nd Ave MST2023-00474
(Site Address) (Permit Number)
Riverside at Scholls Meadow Lot 40
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
.",y fin H*n+•'s/z�rp{-'��' "x#, zx y' ,,... � z t^,k 7. � " '�W�,{v�ajY"�jE a u",q'�.,
Cup ies_ Descr�ponl k. _'t"c x. -�`. is r pie: ':*ai 1pti :� .. 1,: .#. :, t .,
Additional set(s) of plans. 3 Revisions: Site plan
Cross section(s)and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
Fp tf FICE' S ..ONLV `
Routed to Permit Techni •' : Date: 1 l tR
(7, 23 Initials:
Fees Due: El Yes o Fee Descrpti n: Amount Due:
, 2:5.
Special
Instructions:
Reprint Permit(per PE): ❑Yes No 0 Done
Applicant Notified: Date: Initials:
City of Tigard
IIIe
COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit#: ( rat;3 L 71-4
Site Address: 13867 SW 172nd Ave a4 Verified in Accela
Project Name: Riverside at Scholls Meadow Lot/Unit #: 40
Proposal: New Single Detached SFR Zone: RES-C
Housing Type: isI SFR(X Single Detached 0 Duplex❑Triplex❑ADU)0 Rowhouse❑Cottage Cluster❑CYU❑Quad❑Other
Required Site Plan Elements:
M 3 copies of site plan on max 11x17"
X Drawn to standard scale
X North arrow Igl Street and site trees shown / labeled
X Site address, project name, lot #
16 Street names (N/A for SFR)
X Applicant name and phone # 0 C..�,l,e.d ...,.1..,v1..Ji.........;......J (;(4.,NI4....1ble)
Igl Lot and setback dimensions
❑ CA; tfl,y .A....t.., Q,.,....„ 1.,.,1.1yt., X Utility locations &easements
M Footprint of new structure and FFE M Property corner elevations
M Sidewalk/driveway dimensioned El LIDA (>1,000 sf disturbance)
X Lot area and lot coverage percentage ® Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Summary table with calculations for:
03 Drawn to standard scale 0 Total façade area
X Building height dimensioned 0 Total window and door area
O Façade dimensioned
R Windows and doors dimensioned
Cil Garage doors dimensioned
Requir Elements:
(Not required for SFR) 0 Summary table that includes
O Each story dimensioned oor area
O Each story floor area calculated 0 Floor area pe
Planning Review
The following standards have ben.met:
12'building 15 building
Setbacks liii Front:8'perch Rear:10'coy. Side: 3' Min/Max Street Side: 8' / Garage: 20'
35' patio/deck „
Height l Max. Height: Proposed Height: 23 2.5
®Yes 0 N/A Landscape 37% Proposed 7 detailed design elements met, shown on Al. 60%
❑ Yes fil N/A Screening (Quad only) garage width allowed for meeting these design
IX Yes ❑ N/A % Window Coverage 16% Proposed elements; proposed width <60%.
® Yes 0 N/A Garage (SFR Only) Parking (Other Res)
0 Yes 0 N/A Entrance (SFR, Rowhouse, Quad only)
❑ Yes (g) N/A Other building design standards (Rowhouse only)
❑ Yes fil N/A Accessory Structure Standards
❑ Yes ® No Qualifying pre-existing unit exempt from standards (Cottage unit only)
al standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
❑ Yes ❑ N/A t:
❑ Yes 0 N/A Lot Width and i
❑ Yes 0 N/A Pathway
• Iona! standards for Courtyard Units and Cottage Clusters only:
❑ Yes 0 Unit Area:
❑ Yes 0 N/A Floor er story)
❑ Yes ❑ N/A Courtyard
0 Yes 0 N/A Fence
❑ Yes ❑ No MN/A Clean Water Services - Service Provider Letter(lot platted prior to 9/10/1995)
I Yes 0 No ❑N/A Public Facilities Improvement (PFI) Permit:
Required: I&Yes ❑ No
Applied For: lE Yes ❑ No, stop intake
[X Sensitive Lands: 0 Yes 114 No
E Main Land Use Case #s: PDR2021-00001 ❑ Conditions met
NI Applicant notified of land use ex iration te: submit all r i t 8/5/24, obtain c of o by 8/5/26
Approved By Planning: ate: 8/30/2023 g/
Notes l.,P S .
Revision 1: gApproved Not Approved t?reizti„ Date: 10/30 / ??
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: CI 114)/1k 13
Site Plans #:
Building Plans #:
Building Permit #: 6a'Building permit # entered on page 1
Workflow Routing: ["Planning U'Engineering Q'Permit Coordinator Building
Workflow Sign-off: I 'Sign-off for Planning (include notes from planning review)
Route Documents: Ef Engineering: (1) copy of permit application, (1) site plan, (1) building plan
aped original plan review routing form.
�j Building: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: �(l,& p(/y1,{,(i Date: 6 I2ti 42UZ3
Notes: P4A/ 1 .0' 1.- r0 la/31115.1419
Engineering Review
❑ P I Permit:
Slope at building pad: .3
[B'Conditions met prior to issuance of permit
k'Easements (encroachments) per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes �"NO
Assess Water Quantity Fee in-lieu: 0 Yes l8"No
LIDA Facility on lot: 0 Yes 4[No Add Fee: 0 Yes 0 No
C1final Plat Recorded �l /
/1NOTApproved: "" ' /1byai Date: /72
Notes:
Approved By Engineering: Date: /�///'
Revision 1: ❑ Approved Not Approved Date:
Revision 2: 0 Approved 0 Not Approved Date:
Permit Coordinator Review
❑ Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
NG Revisions Required: `ct 1l6 Date notified applicant: q
f( SDC Exemption: ❑ Applied for 0 Received foes not apply
tDC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes 0 N/A Deferred
Parks SDC: Yes ❑ N/A Deferred
LIDA Yes A
K to Issue/Approved by Permit Coordinator: Date: 7,3
Revision 1: ❑ Approved ❑ Not Approved Date: \�
Revision 2: 0 Approved 0 Not Approved Date: